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Hundreds of thousands of people with mental-health conditions are shackled around the world, Human Rights Watch said in a report released on Tuesday.

Robin Hammond for Human Rights Watch/Handout

For 11 months, Benjamin Ballah was shackled inside a church in Liberia. His jailers poured a hot liquid into his nostrils, telling him that the “incense” would “drive out the devil” inside him.

“We had no freedom to move around,” he said. “If you wanted to move, you moved with chains. It was really terrible for me. I felt like I was nobody.”

His brother finally rescued him, bringing him to a hospital where his supposed “demons” were diagnosed as a case of depression. He was treated, went on to university and became a school teacher and mental-health advocate – and today helps to rescue others from the same system of shackles.

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In at least 60 countries across the world, hundreds of thousands of people with mental-health conditions – including children as young as 10 – have been chained or locked in cages or animal sheds because of social stigma or a lack of better care, Human Rights Watch said in a report on Tuesday.

The confinement amounts to torture and it is particularly risky during the COVID-19 pandemic, the group’s researchers say.

Shackling and other forms of confinement, often hidden from scrutiny, still takes place at many private and state-run institutions, religious centres and family homes, frequently in overcrowded or unsanitary conditions, where the shackled people are vulnerable to physical and sexual abuse, the report said. It called for the practice to be banned worldwide.

“Shackling people with mental health conditions is a widespread, brutal practice that is an open secret in many communities,” said the report’s author, Kriti Sharma, senior disability rights researcher at Human Rights Watch.

living in chains worldwide

According to an investigation by Human Rights

Watch, the shackling of mental-health patients

has been documented in 60 countries around

the world.

Countries where Human Rights Watch has found

evidence of people with psychosocial or intel-

lectual disabilities being shackled

JOHN SOPINSKI/THE GLOBE AND MAIL

SOURCE: human rights watch

living in chains worldwide

According to an investigation by Human Rights Watch,

the shackling of mental-health patients has been

documented in 60 countries around the world.

Countries where Human Rights Watch has found evidence

of people with psychosocial or intellectual disabilities

being shackled

JOHN SOPINSKI/THE GLOBE AND MAIL

SOURCE: human rights watch

living in chains worldwide

According to an investigation by Human Rights Watch, the shackling of mental-health patients

has been documented in 60 countries around the world.

Countries where

Human Rights

Watch has found

evidence of people

with psychosocial or

intellectual disabili-

ties being shackled

JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: human rights watch

“People can spend years chained to a tree, locked in a cage or sheep shed because families struggle to cope and governments fail to provide adequate mental health services,” she said in a statement. “It’s horrifying that hundreds of thousands of people around the world are living in chains, isolated, abused and alone.”

The practice of shackling has been documented in almost every region of the world, including 22 countries in Africa, the researchers say.

In Liberia, Mr. Ballah was taken to the church by his mother and grandmother in 2003 because they had no understanding of mental-health issues, he said. He was confined to a room with 30 to 40 other people, all chained to logs.

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The practice continues today. Six people with mental-health conditions – including three children – were found chained to logs in a Christian faith healing centre in Liberia last year. They were shackled after they were accused of witchcraft, the Human Rights Watch report said.

Mr. Ballah now works for an organization that investigates and documents such abuses. “I am a living example of what we can all achieve together if we treat people with mental-health conditions with dignity,” he said on Tuesday at an event marking the report’s release.

The report documented horrific cases of confinement and shackling worldwide. Paul, a man with a mental-health condition in Kisumu, Kenya, said he had been chained for five years. (The report uses first names to protect the identity of victims.) “The chain is so heavy,” he told the researchers. “It doesn’t feel right; it makes me sad. I stay in a small room with seven men. I’m not allowed to wear clothes, only underwear. I eat porridge in the morning and if I’m lucky, I find bread at night.”

Fiera, a woman in Maputo, Mozambique, said her neighbours decided that she was “mad” – so she was taken to a traditional healing centre, where she was forced to take baths in chicken blood, the report said.

In China’s Guangdong province, a woman described how she was forbidden to talk to her aunt, who was locked in a wooden shed because her family was afraid that her mental-health condition would bring a stigma to them. The report cited an estimate that 100,000 people are shackled or locked in cages in one Chinese province alone, Hebei.

In the Indian state of Uttar Pradesh, thousands of people with mental-health conditions were chained like cattle, with their feet in padlocked iron chains, the report said. And in Saudi Arabia, a man with a psychosocial disability was chained for 37 years in a dark sweltering cave in the mountains.

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Of the 60 countries cited in the report, only a handful have laws or policies to ban shackling – and even those laws are often ignored.

Estimating the scale of the problem is difficult. “Shackling remains a largely invisible problem as it occurs behind closed doors, often shrouded in secrecy and concealed even from neighbours due to shame and stigma,” the report said.

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